Prognostic and Predictive Factors for Uterine Sarcomas: A Single Center Experience

Objective: To determine the factors impacting recurrence and long-term survival in uterine sarcoma patients, recognizing the challenge due to histological diversity and lack of definitive treatment. Methods: We reviewed data from uterine sarcoma patients treated from July 2010 to August 2021. Cases were divided into endometrial stromal sarcoma (ESS), leiomyosarcoma (LMS), and others (rhabdomyosarcoma, adenosarcoma), examining clinicopathological features, age, survival rates, and recurrence risk factors. Results: In 43 patients (average age 59.1), most common symptom was vaginal bleeding. Majority were postmenopausal, with a breakdown of 65.1% ESS, 18.6% LMS, and 16.3% other sarcomas. Most (65.1%) were stage 1. Surgery was primarily via laparotomy (95.3%), with 79.1% receiving adjuvant therapy. Recurrence was 18.6%. Significant differences in survival rates were found across groups, with LMS significantly affecting survival and recurrence risk linked to tumor size and surgical stage. Five-year overall survival was 72.1%, and disease-free survival was 67.4%. Conclusion: ESS is the most common uterine sarcoma, but LMS presents the worst prognosis. Tumor size and surgical stage are key to recurrence risk, highlighting the need for further study on adjuvant treatments.